Task Trainers Research Articles

Design, printing optimization, and material testing of a 3D-printed nasal osteotomy task trainer

BackgroundFor difficult or rare procedures, simulation offers an opportunity to provide education and training. In developing an adequate model to utilize in simulation, 3D printing has emerged as a useful technology to provide detailed, accessible, and high-fidelity models. Nasal osteotomy is an essential step in many rhinoplasty surgeries, yet it can be challenging to perform and difficult to receive adequate exposure to this nuanced portion of the procedure. As it currently stands, there are limited opportunities to practice nasal osteotomy due to the reliance on cadaveric bones, which are expensive, difficult to obtain, and require appropriate facilities and personnel. While previous designs have been developed, these models leave room for improvement in printing efficiency, cost, and material performance. This manuscript aims to describe the methodology for the design of an updated nasal osteotomy training model derived from anatomic data and optimized for printability, usability, and fidelity. Additionally, an analysis of multiple commercially available 3D printing materials and technologies was conducted to determine which offered superior equivalency to bone.MethodsThis model was updated from a first-generation model previously described to include a more usable base and form, reduce irrelevant structures, and optimize geometry for 3D printing, while maintaining the nasal bones with added stabilizers essential for function and fidelity. For the material comparison, this updated model was printed in five materials: Ultimaker Polylactic Acid, 3D Printlife ALGA, 3DXTECH SimuBone, FibreTuff, and FormLabs Durable V2. Facial plastic surgeons tested the models in a blinded, randomized fashion and completed surveys assessing tactile feedback, audio feedback, material limitation, and overall value.ResultsA model optimizing printability while maintaining quality in the area of interest was developed. In the material comparison, SimuBone emerged as the top choice amongst the evaluating physicians in an experience-based subjective comparison to human bone during a simulated osteotomy procedure using the updated model.ConclusionThe updated midface model that was user-centered, low-cost, and printable was designed. In material testing, Simubone was rated above other materials to have a more realistic feel.

The use of simulation in liver transplantation anesthesiology fellowship training: A survey of fellowship program directors in the United States.

Liver transplantation surgeries are challenging cases for anesthesiologists. While intra-operative teaching is paramount, simulation has emerged as an educational tool to augment clinical training. A variety of simulation modalities have been described in the literature, but no study has aimed to assess the use of simulation in liver transplantation fellowship training. A 20-question survey detailing the use of simulation, including simulation modalities used and barriers to simulation use, was developed and distributed to 22 program directors for liver transplantation anesthesiology fellowships. An exploratory analysis was performed on multiple-choice and free-text responses. Thirteen program directors completed the survey and were included in our analysis. Most programs (61.5%) did not report the use of simulation for liver transplantation fellow training. Of the programs that did use simulation, four required it as a mandatory component of their curriculum. Task trainers and screen-based simulators were more commonly used by these programs. Faculty availability and interest, as well as a lack of an established curriculum, were cited as major limitations to simulation use. Simulation is an important component of anesthesiology trainee education, as evidenced by the requirement for simulation during residency by the American Council for Graduate Medical Education. Our findings suggest that simulation is an underutilized educational tool that we believe could greatly augment the training of liver transplantation anesthesiology fellows by providing exposure to a wide range of clinical challenges.

Medical Student Instruction in Peripheral Nerve Blockade Utilizing Fresh Cadaver Limbs in a Simulation Center.

Ultrasound imaging is increasingly used in medical practice, but many institutions have room for growth regarding its incorporation into medical education. An elective hands-on course was developed for preclinical medical students using ultrasound to review and enhance their understanding of anatomy as well as to teach ultrasound-guided nerve blocks on cadaver extremities. The hypothesis was that after 3 instructional sessions students would be able to identify 6 anatomic structures, representing 3 types of tissue, in cadaver upper extremities. Students received didactic instruction on ultrasound and regional anatomy at the beginning of each class, followed by hands-on practice, including ultrasound use with phantom task trainers, live models, and fresh cadaver limbs. The primary outcome was the students' ability to correctly identify anatomic structures using ultrasound. Secondary outcomes included their ability to perform a simulated nerve block in the cadaver extremities in comparison with a standardized checklist, as well as their response to a post-course survey. Overall, the students had a 91% success rate in identifying anatomic structures and showed capability of performing simulated nerve block with occasional instructor prompting. The post-course survey revealed that the students felt strongly that both the ultrasound and cadaveric components of the course were beneficial to their education. Ultrasound instruction with live models and fresh cadaver extremities in a medical student elective course resulted in a high degree of recognition of anatomic structures, as well as permitted a valued clinical correlation in the form of simulated peripheral nerve blockade.

Practical Training for Emergency Burr Hole Using Three-Dimensional Printed Task Trainer

Practical Training for Emergency Burr Hole Using Three-Dimensional Printed Task Trainer

Construction of Soft Prep Cadaver Pericardiocentesis Training Model and Implementation Among Emergency Medicine Residents.

This procedure training model is designed for all levels of emergency medicine residents. Pericardiocentesis is a relatively uncommon but potentially life-saving procedure within the scope of Emergency Medicine practice. As such, the Accreditation Council for Graduate Medical Education (ACGME) designates its competency as a requirement within emergency medicine residency programs. Because of its relative rarity, simulation-based training is often utilized to fill the gaps in clinical experience during emergency medicine residency training. There have been several models of pericardiocentesis training, including gel-based models that can be purchased or constructed,1-3 non-gel models,4 and cadaveric models.5 In this paper, we describe the fabrication of a high-fidelity cadaveric model and report emergency medicine resident experience with this model. Training programs can use this model to increase trainee competence and confidence with this high-acuity, low-frequency procedure. By the end of this session, residents will gain increased procedural competence and confidence with pericardiocentesis. Residents will be able to identify necessary supplies for the procedure, identify relevant surface anatomy and ultrasound views, and successfully aspirate fluid from model effusion. We created a pericardial effusion in a soft prep cadaver by placing a catheter into the pericardial sac and then infusing normal saline via intravenous fluid tubing. Learners were then able to practice aspiration of pericardial fluid via landmark and ultrasound-guided approaches under observation by facilitators able to offer real-time feedback. Learners were asked to complete a survey assessing pre-intervention and post-intervention subjective confidence in their ability to perform pericardiocentesis and were asked for qualitative feedback on the experience of using the training model. All residents were able to successfully visualize the pericardial effusion and perform needle aspiration via parasternal and subxiphoid approaches under dynamic ultrasound guidance, allowing needle visualization. All residents reported a subjective increase in procedural confidence and competence after practicing with this training model. Overall, the primary benefit of this training model cited by emergency medicine residents was that it closely approximates reality. This model is re-usable, relatively durable, and reproducible. Emergency medicine residencies associated with academic medical centers that already utilize cadavers for education may relatively easily incorporate this training model into their procedure training curriculum. Pericardiocentesis, simulation, task trainer.

Lateral Canthotomy Task Trainer in an Educational Small Group for Flight Providers

ObjectiveLateral canthotomy is a rare, emergent, vision-preserving procedure to treat orbital compartment syndrome. Using Ericsson's deliberate practice model, we aimed to develop a multimodal small group intervention including a modified low-fidelity task trainer to improve flight physician knowledge and technical competency for lateral canthotomy in the prehospital context. MethodsTwo cohorts of resident (postgraduate year 1) flight physicians received small group training during an all-day competency-based flight physician orientation. The first cohort completed self-report pre- and postintervention assessments. In the second cohort, examiners assessed pre- and postintervention performance. ResultsComparing pre- and postintervention responses (N = 27), the mean agreement with the knowledge of indications increased from 3.7 to 4.8. The mean agreement regarding confidence in skills increased from 2.2 to 4.2 (P < .001). The majority of participants (20/27) indicated the trainer “definitely helped,” whereas 7 of 27 residents indicated the trainer “somewhat helped” them to learn skills. Examiners assessed holistic learner performance (n = 13) as improved from a mean of 3.2 preintervention to 4.7 postintervention, with 11 of 13 learners demonstrating improvement (P < .005). ConclusionWe demonstrate the feasibility of a brief small group training combining multimodal didactics with a modified low-fidelity task trainer. Resident self-assessment and examiner assessment demonstrated improved procedural skill with lateral canthotomy.

Effectiveness of structured self-evaluation of video recorded performance on peripheral intravenous catheter insertion: a randomised control trial study protocol

BackgroundClinical psychomotor skills training is a core component of undergraduate nursing education. Performing technical skills competently involves the use of cognitive and motor function. The training of these technical skills is typically carried out in clinical simulation laboratories. Peripheral intravenous catheter/cannula insertion is an example of a technical skill. It is the most common invasive procedure performed in the healthcare environment. Owing to unacceptable clinical risk and complications to patients, it is imperative that practitioners performing these skills are trained effectively to provide patients with best practice and high-quality care. Technologies identified as innovative teaching methods to help train students in this skill and in the skill of venepuncture include virtual reality, hypermedia and simulators. However, little high-quality evidence exists to confirm such educational approaches are effective.Methods/designThis study is a single-centre, non-blinded, two-group, pre-test and post-test randomised control trial. The randomised control trial will investigate whether a formal structured self-evaluation of videoed performance (experimental group) has an impact on nursing students’ peripheral intravenous cannulation knowledge, performance and confidence. The control group will also be videoed performing the skill but they will not view or self-evaluate their videoed performance. The peripheral intravenous cannulation procedures will be carried out in a clinical simulation laboratory using a task trainer. The data collection tools will be completed online using survey forms. Students will be randomised into the experimental group or into the control group using simple random sampling. The primary outcome measures the nursing students’ knowledge level of the skill of peripheral intravenous cannulation insertion. Secondary outcomes evaluate procedural competence and self-reported confidence and practices in the clinical environment.DiscussionThis randomised control trial will investigate whether this pedagogical approach, using video modelling and self-evaluation, will positively influence students’ knowledge, confidence and performance in the skill of peripheral intravenous cannulation. Evaluating such teaching strategies using stringent methodologies may be impactful in influencing the training provided to healthcare practitioners.Trial registrationThe randomised control trial detailed in this article is an educational research study and so does not fall under the ICMJE definition of a clinical trial as “any research project that prospectively assigns people or a group of people to an intervention, with or without concurrent comparison or control groups, to study the relationship between a health-related intervention and a health outcome”.

Tap-Tap: Learning Endonasal and Percutaneous Nasal Osteotomy Techniques on 3D-Printed Midface Models.

Nasal osteotomy is one of the most challenging steps of rhinoplasty. Lack of hands-on training and confidence with this procedure adds to the complexity for learners and trainees. As three-dimensional (3D) printing becomes increasingly accessible, simulation on 3D printed models has the potential to address this educational need in a safe, reproducible, and clinically realistic manner. The simulation session described in this communication, which utilized our low-cost, 3D-printed nasal osteotomy ($12.37) task trainer, produced both educational and confidence benefits for trainees. Here we describe the design, organization, curriculum, and pilot data for a 3D-printed nasal osteotomy task trainer for the simulation of endonasal and percutaneous nasal osteotomy.

Comparing Objective and Subjective Assessments of Traction in Shoulder Dystocia Simulation Training

OBJECTIVE: The assessment of participants’ applied traction to the fetal mannequin’s head during a simulated shoulder dystocia (SD) management sequence has not been evaluated for inter- or intra-rater reliability. We sought 1) to compare preceptors’ subjective assessments of applied force to the objective measurements derived from embedded force sensors; 2) to determine whether simulation training that includes assessment of force reduces participants’ applied traction; and, 3) to determine whether force-based simulation training improves recognition of SD and reduces brachial plexus injury (BPI) in the clinical setting. METHODS: Participants completed a baseline assessment in which they were asked to manage a case of SD using a task trainer (PROMPT, Limbs & Things) that includes a fetal mannequin that measures traction applied to the head. Two preceptors subjectively determined whether traction on the fetal head was appropriate. Participants completed training and then performed the same scenario for the final assessment. Clinical outcomes of SD deliveries were compared before and after a one-year program of simulation training of all L&D providers. RESULTS: There was poor agreement between preceptors’ subjective assessments of force and the objective force measurements, with kappa scores ranging from 0.04-0.17, poor inter-rater reliability (ICC = 0.2905) and intra-rater reliability (ICC =0.4391). Nevertheless, the mean peak force applied to the fetal mannequin decreased from 87N at the baseline assessment to 70N at the final assessment. Clinically, training increased awareness of SD and the decreased the rate of SD-associated BPI. (Table) CONCLUSION: SD simulation training is effective at decreasing the amount of force applied to the fetal head. Objective measurement of force is an important aspect of SD simulation training as preceptors are unable to reliably estimate force

Modeling, Control, and Clinical Validation of an Upper-limb Medical Education Task Trainer for Elbow Spasticity and Rigidity Assessment.

The goal of this study was to validate a series elastic actuator (SEA)-based robotic arm that can mimic three abnormal muscle behaviors, namely lead-pipe rigidity, cogwheel rigidity, and spasticity for medical education training purposes. Key characteristics of each muscle behavior were first modeled mathematically based on clinically-observed data across severity levels. A controller that incorporated feedback, feedforward, and disturbance observer schemes was implemented to deliver haptic target muscle resistive torques to the trainee during passive stretch assessments of the robotic arm. A series of benchtop tests across all behaviors and severity levels were conducted to validate the torque estimation accuracy of the custom SEA (RMSE: ~ 0.16 Nm) and the torque tracking performance of the controller (torque error percentage: < 2.8 %). A clinical validation study was performed with seven experienced clinicians to collect feedback on the task trainer's simulation realism via a Classification Test and a Disclosed Test. In the Classification Test, subjects were able to classify different muscle behaviors with a mean accuracy > 87 % and could further distinguish severity level within each behavior satisfactorily. In the Disclosed Test, subjects generally agreed with the simulation realism and provided suggestions on haptic behaviors for future iterations. Overall, subjects scored 4.9 out of 5 for the potential usefulness of this device as a medical education tool for students to learn spasticity and rigidity assessment.

Simulation-based Mastery Learning Improves Emergency Medicine Residents' Ability to Perform Temporary Transvenous Cardiac Pacing.

Temporary transvenous cardiac pacing (TVP) is a critical intervention that emergency physicians perform infrequently in clinical practice. Prior simulation studies revealed that emergency medicine (EM) residents and board-certified emergency physicians perform TVP poorly during checklist-based assessments. Our objective in this report was to describe the design and implementation of a simulation-based mastery learning (SBML) curriculum and evaluate its impact on EM residents' ability to perform TVP. An expert panel of emergency physicians and cardiologists set a minimum passing standard (MPS) for a previously developed 30-item TVP checklist using the Mastery Angoff approach. Emergency medicine residents were assessed using this checklist and a high-fidelity TVP task trainer. Residents who did not meet the MPS during baseline testing viewed a procedure video and completed a 30-minute individual deliberate practice session before retesting. Residents who did not meet the MPS during initial post-testing completed additional deliberate practice and assessment until meeting or exceeding the MPS. The expert panel set an MPS of correctly performing 28 (93.3%) checklist items. Fifty-seven EM residents participated. Mean checklist scores improved from 13.4 (95% CI 11.8-15.0) during baseline testing to 27.5 (95% CI 26.9-28.1) during initial post-testing (P < 0.01). No residents met the MPS at baseline testing. The 21 (36.8%) residents who did not meet the MPS during initial post-testing all met or exceeded the MPS after completing one additional 30-minute deliberate practice session. Emergency medicine residents demonstrated significantly improved TVP performance with reduced variability in checklist scores after completing a simulation-based mastery learning curriculum.

Efficacy of a single-day task trainer-based extracorporeal membrane oxygenation training course.

Extracorporeal membrane oxygenation (ECMO) is an advanced medical technology used to treat respiratory and heart failure. The coronavirus pandemic has resulted in significantly more ECMO patients worldwide. However, the number of hospitals with ECMO capabilities and ECMO-trained staff are limited. Training of personnel in ECMO could supplement this demand. To evaluate our previously developed ECMO course using a task trainer-based training, as opposed to an existing live tissue-training model, and determine if such a program was adequate and could be expanded to other facilities. Seventeen teams, each consisting of a physician and nurse, underwent a 5 hour accelerated ECMO course in which they watched prerecorded ECMO training lectures, primed circuit, cannulated, initiated ECMO, and corrected common complications. Training success was evaluated via knowledge and confidence assessments and observation of each team attempting to initiate ECMO while troubleshooting complications on a Yorkshire swine. Seventeen teams successfully completed the course. Sixteen teams (94%, 95% CI=71%-100%) successfully placed the swine on veno-arterial ECMO. Of those 16 teams, 15 successfully transitioned to veno-arterial-venous ECMO. The knowledge assessments and confidence levels of physicians and nurses increased by 24.3% from pretest (mean of 65.3%, SD 14.4%) to posttest (mean of 89.6%, SD 10.3%), p < 0.0001. An abbreviated one day lecture and hands-on task trainer-based ECMO course resulted in a high rate of successful skill demonstration and improvement of physicians' and nurses' knowledge assessments and confidence levels, similar to our previous live tissue training program.

A 3D-Printed Ultrasound Task Trainer for the Practice of Hip Joint Injections

Ultrasonography is often the preferred method of imaging for needle-guided procedures of the hip joint, including aspirations, local anaesthetic injections, and the use of corticosteroids. Phantoms (i.e., training devices mimicking human tissue and bony structures under acoustic sonography) are used to help train medical professionals to perform these procedures accurately, emphasising the art of physical simulation in unison with didactic learning. In the authors’ study, 3D printing technology was used to simulate an anatomically accurate human hip joint, with the hopes of creating an affordable and customisable ultrasound hip trainer, allowing novice sonographers to practice guided injections to hone their skills before performing these procedures on human subjects.

The ABCs of a gynaecological teaching associate (GTA) programme

Gynaecological/Male Urogenital Teaching Associate (GTA/MUTA) methodology is considered the gold standard of invasive genital examination technique. Lay persons are trained in the technique of invasive genital examinations and patient-centred, trauma informed communication, and autonomously instruct learners on how to comfortably perform this examination using their own bodies as a teaching tool. GTAs/MUTAs function simultaneously as an autonomous instructor and a simulated patient during the exam. GTAs and MUTAs instruct clinical invasive examination techniques in a structured educational setting with a predetermined curriculum on which they have been trained, while letting learners perform these exam techniques on their bodies. Existing alternatives to GTA/MUTA education include the use of anesthetized patients, cadavers, plastic anatomical models (task trainers) and/or voluntary examinations on peers. There are unique benefits to the GTA/MUTA programme from both an institutional and learner perspective. Learner’s benefits unique to GTA/MUTA education include decreased learner anxiety [1], immediate feedback on examination technique with regard to patient’s physical comfort, and the opportunity to practise patient communication skills while performing such examinations. Institutional benefits unique to GTA/MUTA methodology are that after the initial setup cost, funds are saved removing the need for faculty to perform the examination instruction. Learner proficiency is higher compared to learners taught by physicians [1], and increased proficiency saves time and cost associated with learners being taken off clinical rotation to receive supplemental genital examination technique instruction. The use of simultaneous patient-instructors also introduces ‘elements of sensitivity and humanism’ to the examination [2] by having students learn to involve their patient and incorporate their perspective with regard to comfort and patient education information. By learning this examination from GTAs/MUTAs, a new model of physician patient relationship is taught, with GTAs/MUTAs functioning as informed collaborators rather than docile, uninformed patients [3]. In order to implement such a programme in an institution, among the first tasks is to obtain funding. This funding can be sought from grants or via institutional funds. Institutions may even choose to grow their GTA/MUTA programme to contract with outside institutions where this clinical examination instruction is needed. Other preparatory steps include establishing a curriculum, observing an established GTA/MUTA programme session to assess the format, and recruitment and training of GTAs and MUTAs. Once the programme is established, a clinical skills training day may be implemented. Implementing such a programme improves the learners’ experience and provides them with an increased understanding of sound technique that will benefit their patients in the long term. 1. Theroux R, Pearce C. Graduate students’ experiences with standardized patients as adjuncts for teaching pelvic examinations. Journal of the American Academy of Nurse Practitioners. 2006;18(9):429–35. 2. Kretzschmar RM. Evolution of the Gynecology Teaching Associate: an education specialist. American Journal of obstetrics and gynecology. 1978;131(4):367–73. 3. Underman K. Feeling Medicine: How the Pelvic Exam Shapes Medical Training. New York, New York University Press; 2020.

A Novel Ocular Tonometry Task Trainer.

The measurement of intraocular pressure via ocular tonometry is a skill necessary for the evaluation of emergency department patients with ocular complaints. Accurate results inform the use of time-sensitive medications or invasive procedures. We sought to develop and evaluate an affordable, realistic, and reproducible task trainer to allow Emergency Medicine residents and medical students to practice tonometry. We placed an angiocatheter into the vitreous chamber of a swine eye through the optic nerve stump and sealed it with a purse string suture and cyanoacrylate glue. This allowed us to connect intravenous extension tubing and use a saline-filled syringe to repeatedly adjust intraocular pressure in real time. Optionally, this model can be mounted in a polystyrene foam mannequin head to enhance realism and facilitate practice. The task trainer was implemented in medical student and Emergency Medicine resident education at Vanderbilt University Medical Center. Thirty-six learners participated in the study, all of whom completed pre-course and post-course surveys. Among all learners, the mean comfort with performing tonometry improved significantly (3.26 to 7.64 {Z = -4.95, p < 0.005}). The mean confidence in the accuracy of measurements also increased (3.11 to 7.56 {Z = -4.8, p < 0.005}). On a 10-point scale, learners felt this task trainer was highly helpful in increasing their comfort with and the ability to perform tonometry (mean 9.19 {SD 1.19}). We have developed a low-cost and easily constructed ocular tonometry task trainer that resulted in significant improvement in learner comfort and confidence.

3D-printed procedural task trainer for the aspiration of penile corpus cavernosa in ischaemic priapism.

The development and initial clinical assessment of a novel 3D-printed procedural task trainer for the aspiration of penile corpus cavernosa in ischaemic priapism. A task trainer for the aspiration of penile corpus cavernosa was designed and manufactured using commercially available 3D printing equipment. The trainer was assessed in two separate training sessions led by faculty investigators. Participants in the sessions were asked to complete a post-procedure survey with regards to the utility and realism of the task trainer. The participants (n=14) covered a broad spectrum of clinician types. The trainer was perceived by the participants as being anatomically realistic, and especially while under drapes provided a reasonable facsimile of real clinical setup. The trainer proved resilient to multiple attempts at aspiration by multiple participants. Participant and facilitator feedback indicates that the task trainer is a useful platform to train for what is a low frequency, but high stakes, procedure. Small numbers of participants preclude statistical rigour and certainty regarding overall performance of the trainer. However, the uniformity in the responses would suggest that this is indeed a task trainer that is 'fit for purpose'.

8895 Fundamentals of Laparoscopic Surgery for Senior Medical Students Entering Surgical Residency

<h3>Study Objective</h3> The Fundamentals of Laparoscopic Surgery (FLS) is mandatory for OBSTETRICS AND GYNECOLOGY residency. We aimed to evaluate the usefulness of FLS for fourth year medical students to gain confidence and to determine quantitative improvement in FLS tasks and exam. <h3>Design</h3> On the first and last day of the course, students completed a Likert scale (1-10) self-assessment rating confidence in knowledge of laparoscopy, confidence in technical laparoscopic skills, and satisfaction with laparoscopic training during medical school. Students also completed the FLS written assessment. For two weeks, students had didactics and practiced the five practical tasks on FLS trainers: peg transfer, circle cutting, endoloop, extracorporeal and intracorporeal knot tying. Pre and post practice times were recorded. Students were evaluated by OBSTETRICS AND GYNECOLOGY faculty mentors with a pre and post validated global assessment tool per FLS task. <h3>Setting</h3> Fourth year medical school elective in an academic setting. <h3>Patients or Participants</h3> Sixteen fourth year medical students enrolled in the two-week FLS elective course over two years (2021-2022). <h3>Interventions</h3> Participants received daily didactic lessons taught by OBSTETRICS AND GYNECOLOGY faculty, as well as guided practice sessions utilizing laparoscopic task trainers. All interventions were measured pre and post didactic sessions. <h3>Measurements and Main Results</h3> Overall, students felt more confident in their combined laparoscopic knowledge, skills, and training assessment following the course (2.3 (1.7) vs. 6.1 (2.0), p<0.001). Students showed improvement on the written exam (.62 (.10) vs. .87 (.06), p<0.001). The mean time to complete all five of the FLS tasks decreased (seconds, 247 (135) vs. 143 (102), p<0.001). Finally, the average combined faculty global rating assessment of the students' performance improved (2.3 (0.4) vs. 3.9 (0.3), p<0.001). Feedback from students was universally positive. <h3>Conclusion</h3> Implementing the FLS curriculum for fourth year medical students increases confidence in laparoscopic knowledge and performance of technical skills prior to entering a surgical residency.

Learning Clinical Skills Using Haptic vs. Phantom Head Dental Chair Simulators in Removal of Artificial Caries: Cluster-Randomized Trials with Two Cohorts' Cavity Preparation.

Dental task trainer simulators using haptics (virtual touch) offers a cost-effective method of teaching certain clinical skills. The purpose of this study is to evaluate students' performance in removing artificial caries after training with either a haptic dental chair simulator with virtual reality or a traditional dental chair simulator with a mannequin head. Cluster Randomized Controlled Trials in two cohorts, both Year 1 dental students. Students taught using traditional dental chair simulators were compared with students taught using haptic-based simulators on their ability to cut a cavity in a plastic tooth following training. Across both cohorts, there was no difference in the quality of cavity cut, though students' technique differed across the two simulator groups in some respects. No difference was seen across both cohorts in the quality of cavity cut for a simple preparation, though students in the haptic condition performed less well in the more demanding task. Moreover, students in the haptic group were also less likely to be perceived to be 'holding the instrument appropriately'. These findings suggest further investigation is needed into the differences in handling of instruments and level of clinical task difficulty between the simulators.

Comparing Task Trainers to Standardized Patients for Gynecologic Assessment Skills

A quality improvement project was undertaken to assess nurse practitioner student feedback regarding low-fidelity task trainers and standardized patients for assessment of gynecologic exams. Initial practice with low-fidelity equipment helps students become familiar with equipment and technique, whereas use of standardized patients helps students apply those techniques and adapt them to individual persons. Use of standardized patients enabled students to engage in trauma-informed care while learning sensitive and proficient gynecologic exams. Barriers such as cost, availability of live models, and continued training will need to be addressed in future projects.

A Porcine-Based Task Trainer for the Instruction of Seidel's Test and Ocular Foreign Body Removal.

Ophthalmologic emergencies account for tens of thousands of patients presenting to the emergency department (ED) each year. Studies continue to show that ophthalmology education in medical school is limited, and this leads to many resident physicians who lack confidence in their ophthalmological examination and procedural skills if opportunities to practice these skills are not deliberately sought out during their training. Medical simulation continues to be an excellent way for physicians to learn and master these anxiety-inducing procedures. We present a newly modified, innovative, and realistic porcine-based emergency ophthalmologic procedural task trainer with live television screen projection to further improve Emergency Medicine (EM) resident education on the performance of Seidel's test and ocular foreign body removal.