Validation of a Low-cost Optic Nerve Sheath Ultrasound Phantom: An Educational Tool

Cost-Effective Training Models in Point-of-Care Ultrasound for Medical Students in Emergency Medicine: An Evaluation of Current Resources

Background

Ultrasound is becoming more widely utilized in clinical practice; however, its effectiveness is limited by the operator’s skills. Simulation models are attractive options for developing skills because they allow inexperienced users to practice without the risk of endangering patients.

Objective

The purpose of this study was to identify commercially available and homemade ultrasound models to describe them in terms of materials, cost, and whether they are high- or low-fidelity for medical student education.

Methods

This is an investigational study on cost-effective ultrasound training methods for medical students. Our study was performed using search engines in Google, Google Scholar, and PubMed to search for models for the following five modalities: foreign body identification, intravenous (IV) injection training, abdominal ultrasound, ocular ultrasound, and ultrasound-guided lumbar puncture training.

Results

Most homemade models for foreign body identification, IV injection training, and ocular ultrasound could be created for less than $20. IV injection training models were the cheapest commercially available models. There are multiple commercially available options for abdominal ultrasound models, but no options were found for homemade construction. The construction cost for lumbar puncture models was larger due to the need to purchase an anatomically accurate set of lumbar vertebrae.

Conclusions

This study provides initial guidance and suggestions for ultrasound training models that are currently available. Ultrasound models that can be cheaply made or purchased increase accessibility for medical students to gain early exposure in a cost-effective and safe manner.

Review of simulation model for education of point-of-care ultrasound using easy-to-make tools

Point-of-care ultrasound (POCUS) is a powerful diagnostic tool and provides treatment guidelines in acute critical settings. However, the limitation of using POCUS is operator dependent. Appropriate and validated training for acquiring and using skills in practice must be conducted before using POCUS in clinical settings in order to keep patients safe. Simulation education models have been introduced as a way to solve and overcome these concerns. However, the commercial simulator with sufficiently secured fidelity is expensive and not always available. This review focused on the inexpensive and easily made simulators for education on POCUS in critical specific situations related to the airway, breathing, circulation, and disability. We introduced the simulators that used non-infectious materials, with easily transportable features, and that had a sonographic appearance reproducibility similar to human tissue. We also introduced the recipe of each simulator in two parts: Materials surrounding disease simulators (surrounding materials) and specific disease simulators themselves (target simulators). This review article covered the following: endotracheal or oesophageal intubation, lung (A-lines, B-lines, lung sliding, and pleural effusions such as hemothorax), central vein access, pericardial fluid (cardiac tamponade), the structure related to the eyes, soft tissue abscess, nerve (regional nerve block), and skull fracture simulators.

A New Inexpensive Simulation Model for Ultrasound Assessment of Optic Nerve Sheath Diameter

BACKGROUND

Sonographic measurement of optic nerve sheath diameter (ONSD) is becoming increasingly accepted as a diagnostic modality to detect elevations in intracranial pressure. As this technique becomes more widespread, methods to address the inherent operator-dependent nature of this modality will need to be developed. We propose a novel low-cost model to accurately simulate sonographic ONSD measurement for purposes of training and assessment.

METHODS

We designed models composed of medical tubing of various diameters readily available from typical hospital supplies and suspended them in gelatin. The models were evaluated by ultrasound by three expert point-of-care sonographers using a standard linear array probe and technique proposed in the literature.

RESULTS

This model generates faithful simulation of the ONS that closely approximates in vivo images and can be used to produce accurate, reproducible measurements. Materials are low cost and easy to acquire and assemble.

CONCLUSIONS

Our model provides realistic simulated images of the ONS. Through comparison of sonographic measurements to the known tube diameters, this model serves as a promising inexpensive tool to teach the method of ultrasound assessment of ONSD or as a way to determine accuracy of this novel ultrasound technology.

Simulation in Neurocritical Care: Past, Present, and Future

Simulation-based medical education is a technique that leverages adult learning theory to train healthcare professionals by recreating real-world scenarios in an interactive way. It allows learners to emotionally engage in the assessment and management of critically ill patients without putting patients at risk. Learners are encouraged to work at the edge of their expertise to promote growth and are provided with feedback to nurture development. Thus, the training is targeted to the learner, not the patient. Despite its origins as a teaching tool for neurological diseases, simulation-based medical education has been historically abandoned by neurocritical care educators. In contrast, other critical care educators have embraced the technique and built an impressive foundation of literature supporting its use. Slowly, neurocritical care educators have started experimenting with simulation-based medical education and sharing their results. In this review, we will investigate the historical origins of simulation in the neurosciences, the conceptual framework supporting the technique, current applications, and future directions.