An interactive teaching device simulating intussusception reduction

Abstract

Intussusception is relatively uncommon, occurring in 0.5 to 2.3 cases per 1,000 live births in the USA. Radiology residents, therefore, have few opportunities to participate in intussusception reduction during training, and practicing radiologists encounter it infrequently. Training is essential, as successful reduction avoids surgery. The judgment involved in reducing an intussusception is best gained with experience. We developed a training device that simulates fluoroscopic intussusception reduction with air. The device consists of a doll that contains a cylinder with similar stress and strain characteristics to the human colon. The trainee pumps air into the cylinder through a rectal tube using a standard hand-held air reduction pump. A sensor measures the pressure within the chamber and transmits readings to a computer, which displays images from actual intussusception reductions based on the pressure maintained within the device. A random component in the software gives the user a new experience each time and models uncertainties in the actual reduction process, including perforation. This intussusception reduction simulator can enhance resident education, giving residents the opportunity to practice this technique before employing it on a real patient. The simulator can also help practicing radiologists become more comfortable with intussusception air reduction.Electronic supplementary materialThe online version of this article (doi:10.1007/s00247-010-1764-x) contains supplementary material, which is available to authorized users.

Improvements to a Novel Device Simulating Pneumatic Intussusception Reduction

“…For these reasons, pediatric radiologists increasingly favor a pneumatic approach [15,17]. We therefore built [8] and have now improved a simulator based on air reduction technique.…”

“…The authors sought to improve the prototype of the intussusception reduction simulator [8] with the goal of producing a device that other radiology training programs could purchase and use. The original design includes a custom machined polyvinyl chloride chamber and spring piston assembly that approximates the stress and strain properties of the colon.…”

“…In 2010, Stein-Wexler et al [8] created a prototype for a training device that simulates the reduction procedure. Feedback about this device has led us to make improvements that transform it into a robust and versatile simulator that will be offered to programs that wish to supplement patient-based learning with a simulation model.…”

Radiology residents’ experience with intussusception reduction

“…Given that the typical radiology resident’s exposure to intussusception reduction is limited, most are interested in enhanced learning via an intussusception simulation model [ 6 ]. Computer simulation is indeed playing an increasing role in training both residents and practicing radiologists in uncommon, new or technically demanding procedures [ 7 – 9 ].…”

Unpacking the Broad Landscape of Intraoperative Stressors for Clinical Personnel: A Mixed-Methods Systematic Review

“…Therefore, we excluded studies reporting patients or caregivers stress as well as examining stress of clinical personnel outside the OR. Also, studies using the term "stress" in different contexts such as mechanical stress of tissues 52 and stress urinary incontinence 53 were excluded. If a paper did not clarify its study goals regarding intraoperative stress in its title, we left them for the next round of screening.…”