Dove, Jesse

Abstract Training adult learners to use ultrasound in clinical practice relies on the ability of the learner to apply visuospatial concepts to the anatomy of the human body. We describe a visuospatial trainer that replicates the housing of an ultrasound transducer, through which a linear laser projects light in the same plane and orientation as the ultrasonic sound waves. We use this trainer in combination with a porcine heart dissection laboratory to teach bedside cardiac ultrasound and transthoracic echocardiography (TTE). Off-the-shelf components, including an on/off switch, a laser, and 2 ampere batteries are connected in series and placed inside the 3-dimensional (3D)–printed housing. The trainer's laser emission projects a red line that visually represents the ultrasound's field. Learners project the laser against a porcine or human heart in the orientation of the TTE window they wish to obtain and then dissect the heart in that plane, allowing for visualization of how grayscale images are obtained from 3D structures. Previous research has demonstrated that visuospatial aptitude is correlated with ultrasound procedural performance. We present this trainer and educational method as a specific training intervention that could enhance the visuospatial ability of the ultrasound learner. This visuospatial trainer and educational method present a novel process for enhancing learner understanding of 2-dimensional ultrasound images as they relate to 3D structures. Having a clear understanding of how images are generated in cross section may translate into more proficient adaptation of cardiac ultrasound and TTE.

Although studies on simulation of rare complications have become more common in the trauma and obstetric literature, there is a paucity of studies on simulation of rare laparoscopic emergencies. High-fidelity models, virtual reality systems, and porcine labs are available; however, their cost limits wider use and repetition of skills. A low-cost, laparoscopic entry and emergency model was created using on-hand base parts. A convenience sample of obstetrics/gynecology and general surgery residents and attending surgeons completed a laparoscopic entry and emergency scenario using an innovative model in the multidisciplinary simulation center. A total of 29 gynecology, urology, and general surgery residents, fellows, and attending surgeons participated in the laparoscopic emergency simulation drill. Of the 29 participants of the laparoscopic emergency simulation drill using the model, 27 (93.1%) agreed or strongly agreed that the simulated drill approximates the stress of a vascular injury during laparoscopy and 27 (93.1%) agreed or strongly agreed that the model set up appears appropriate for approximating a retroperitoneal hematoma. The reusable, laparoscopic simulation model and emergency drill were rated favorably by participants. The model and drill have the potential to be used for multidisciplinary drills that include anesthesiologists, surgical nurses, surgical technologists, and surgeons.