Virtual lumbar puncture simulators: where are we today?

Abstract

The lumbar puncture is an important procedure used in different specialties in medicine, such as neurology and anesthesiology. This procedure is considered complex, and the medical students believe they have not enough experience and confidence to perform it. That is the reason why some researchers are interested in proposing to create solutions to provide a better training of this procedure. This review aims to present a comparison between 10 virtual lumbar puncture simulators developed since 2000, where nine of them use a haptic device to represent a realistic procedure. In addition, the physical and virtual components are discussed, including the haptic device, the haptic algorithm, the virtual environment and the evaluations of the simulators. The contribution of this review is to recognize the limitations and strengths to identify some optimal requirements for the design, development, or selection of the software/hardware for the next generation of virtual lumbar puncture simulators.

Development of a lumbar puncture virtual simulator for medical students training: A preliminary evaluation

“…According to the simulators presented in Ref. (25), this simulator is the only one compatible with different haptic devices, giving the possibility of adapting to different institutions and budgets. However, the force haptic feedback received by the user depends on this device, and their realism and usability will depend on it.…”

“…In order to design a useful tool for physicians and medical students, the development was based on the basic characteristics mentioned by Ref. (25) and on the UCD approach, where 13 user requirements were identified. During the prototyping of the LP simulator, different physicians provided feedback, and according to this, the system was modified, in order to create a user-centred simulator.…”

“…The design of the LPVirSim was based on the characteristics mentioned in Ref. (25) and on 13 requirements obtained through the UCD approach 26 with a questionnaire, an interview, and an explanation of the LP performed with a mannequin. i) The questionnaire was applied to nine physicians experienced in the LP procedure; in this questionnaire, they were asked about the activities performed during the LP, the most common mistakes of the novices, and their experience with their first LP on a patient, this questionnaire is available in https://bit.ly/3AYil9v.…”

“…However in Ref. (25) the authors compared and analysed virtual LP simulators developed since 2000 to identify the basic characteristics that should be considered in the design and development of this type of simulators, such as the possibility of including anatomical variations to represent patients with different characteristics; opacity changes in the tissues according to the position of the needle tip; a representation of CSF sampling, and the use of a haptic device with force feedback.…”