Clinical Cadavers as a Simulation Resource for Procedural Learning

Kovács, George; Levitan, Richard M.; Sandeski, Rob

doi:10.1002/aet2.10103

Cited by 56 publications

(47 citation statements)

References 88 publications

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“…Further, teaching and learning of technical skills in the ICU environment seems determined by caseload and, particularly for emergency skills, even more by suitable teaching cases in respective (emergency) situations. The transfer of training from the clinical setting to "safe environments" such as training on human cadavers in a wet lab may have beneficial effects on teaching/ learning experiences [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Simulation training for emergency skills: effects on ICU fellows’ performance and supervision levels

Zante

Schefold

2020

BMC Med Educ

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Background The application of manual emergency skills is essential in intensive care medicine. Simulation training on cadavers may be beneficial. The aim of this study was to analyze a skill-training aiming to enhance ICU-fellows´ performance. Methods A skill-training was prepared for chest tube insertion, pericardiocentesis, and cricothyroidotomy. Supervision levels (SL) for entrustable professional activities (EPA) were applied to evaluate skill performance. Pre- and post-training, SL and fellows´ self- versus consultants´ external assessment was compared. Time on skill training was compared to conventional training in the ICU-setting. Results Comparison of pre/post external assessment showed reduced required SL for chest tube insertion, pericardiocentesis, and cricothyroidotomy. Self- and external assessed SL did not significantly correlate for pre-training/post-training pericardiocentesis and post-training cricothyroidotomy. Correlations were observed for self- and external assessment SL for chest tube insertion and pre-assessment for cricothyroidotomy. Compared to conventional training in the ICU-setting, chest tube insertion training may further be time-saving. Conclusions Emergency skill training separated from a daily clinical ICU-setting appeared feasible and useful to enhance skill performance in ICU fellows and may reduce respective SL. We observed that in dedicated skill-training sessions, required time resources would be somewhat reduced compared to conventional training methods.

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Section: Introductionmentioning

confidence: 99%

Simulation training for emergency skills: effects on ICU fellows’ performance and supervision levels

Zante

Schefold

2020

BMC Med Educ

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“…The teaching of patient-care principles such as surgical positioning or operating room safety is also traditionally taught through these methods, or with cadaveric models, which has inherent limitations in accessibility and cost (Ferrada, Anand, Amendola, & Kaplan, 2014;Grow, 2017;Gunderman & Wilson, 2005;Kovacs, Levitan, & Sandeski, 2018). after utilizing the dynamic model, however only 40% (4/10) of participants answered correctly after utilizing the static model.…”

Section: Discussionmentioning

confidence: 99%

“…For this reason, these injection models tend to reflect a rudimentary structure of individual spinal elements, and provide a limited means for studying or teaching specific spinal pathologies or patient‐specific anatomical features, especially regarding the subtle changes of bony remodeling in degenerative conditions that affect the kinematics of the spine as a whole (Clifton, Nottmeier, Damon, Dove, Chen, & Pichelmann, 2019). The teaching of patient‐care principles such as surgical positioning or operating room safety is also traditionally taught through these methods, or with cadaveric models, which has inherent limitations in accessibility and cost (Ferrada, Anand, Amendola, & Kaplan, 2014; Grow, 2017; Gunderman & Wilson, 2005; Kovacs, Levitan, & Sandeski, 2018). Dynamic 3D‐printing methodology presents a new dimension of educational modeling for medical educators to develop accurate and anatomic or pathology‐specific phantoms that have multi‐dimensional uses for teaching and training purposes.…”

Section: Discussionmentioning

confidence: 99%

Investigation of a three‐dimensional printed dynamic cervical spine model for anatomy and physiology education

et al. 2020

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Introduction: Three-dimensional (3D) printing of anatomical structures is a growing method of education for students and medical trainees. These models are generally produced as static representations of gross surface anatomy. In order to create a model that provides educators with a tool for demonstration of kinematic and physiologic concepts in addition to surface anatomy, a high-resolution segmentation and 3D-printingtechnique was investigated for the creation of a dynamic educational model. Methods: An anonymized computed tomography scan of the cervical spine with a diagnosis of ossification of the posterior longitudinal ligament was acquired. Using a high-resolution thresholding technique, the individual facet and intervertebral spaces were separated, and models of the C3-7 vertebrae were 3D-printed. The models were placed on a myelography simulator and subjected to flexion and extension under fluoroscopy, and measurements of the spinal canal diameter were recorded and compared to in-vivo measurements. The flexible 3D-printed model was then compared to a static 3D-printed model to determine the educational benefit of demonstrating physiologic concepts. Results: The canal diameter changes on the flexible 3D-printed model accurately reflected in-vivo measurements during dynamic positioning. The flexible model also was also more successful in teaching the physiologic concepts of spinal canal changes during flexion and extension than the static 3D-printed model to a cohort of learners. Conclusions: Dynamic 3D-printed models can provide educators with a cost-effective and novel educational tool for not just instruction of surface anatomy, but also physiologic concepts through 3D ex-vivo modeling of case-specific physiologic and pathologic conditions.

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“…Studies have shown that simulation-based teaching may improve patient safety through specific training and protocols [10]. According to recent literature, learners feel that using cadavers provides them with a more practical simulation resource [12]. The act of visualizing and practicing hands-on techniques on cadavers has been advocated as a worthwhile educational tool [13,14].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hands-On Versus Online Learning in Teaching Ultrasound Skills for Achilles Tendon Rupture: A Pilot Study

Das¹,

Kapoor²,

Brown³

et al. 2020

Cureus

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In the emergency department, the diagnosis of an Achilles tendon rupture (ATR) is reportedly missed in greater than 20% of cases. A limited number of studies evaluate the use of cadaver models as a potential ultrasound teaching and training modality. We hypothesize that emergency medicine residents can effectively utilize point-of-care ultrasound (POCUS) on cadaver models and a focused teaching intervention to assess their ability to detect ATRs. Methods A prospective study of 23 EM residents was performed. All participants in the study were divided into two learner groups: (a) independent and (b) hands-on. The independent learner group received a 30-minute online didactic lecture demonstrating how to diagnose ATRs. The hands-on learner group received direct instruction on cadaver lower leg models with a ruptured and normal Achilles tendon (AT). Both groups then participated in identifying either normal or ruptured ATs on six cadaver lower leg models. Results The sensitivity and specificity were 89% and 82% in the independent learner group 96% and 100% in the hands-on learner group, respectively. The overall sensitivity and specificity were 91% and 88%, respectively. There was a trend toward successful identification with increased years of residency training. Conclusions In this study, lower leg and ankle cadaver models were found to be as effective as an independent learner model for potential POCUS teaching and training modality in both novice and more advanced trainees.

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Clinical Cadavers as a Simulation Resource for Procedural Learning

Cited by 56 publications

References 88 publications

Simulation training for emergency skills: effects on ICU fellows’ performance and supervision levels

Simulation training for emergency skills: effects on ICU fellows’ performance and supervision levels

Investigation of a three‐dimensional printed dynamic cervical spine model for anatomy and physiology education

Comparison of Hands-On Versus Online Learning in Teaching Ultrasound Skills for Achilles Tendon Rupture: A Pilot Study

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