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Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to...

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Ultrasound Simulators Tripp Bell, MD University of South Carolina School of Medicine
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Page 1: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Ultrasound Simulators

Tripp Bell, MD

University of South Carolina

School of Medicine

Page 2: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Objectives

• Give a brief history of simulation in medicine

• Describe the types of ultrasound simulators

• Show how ultrasound simulation can be used in medical education

Page 3: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

What is a simulator?

• An educational tool which imitates real life scenarios

• Provides trainees a means to practice a task with the aim of improving performance in the real life setting

Page 4: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

History of Simulation in Medicine

• Resusci-Anne mannequin developed in the 1950’s by Dr. Peter Safar and Dr. Bjorn Lind to simulate artificial ventilation and chest compressions

Page 5: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

History of Simulation in Medicine

• Simulators to practice surgical procedures

Page 6: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

History of Simulation in Medicine

• Simulators for ultrasound which is a highly operator dependent imaging modality

Page 7: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Types of Ultrasound Simulators

• Online

• Mannequin

• Phantoms

Page 8: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Online Simulators

• Web based programs that use mouse-operated controls to change scan planes and simulate probe manipulations

• Displays an ultrasound image corresponding to the particular scan plane

Page 9: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Mannequin Based Simulators

• Mannequin

• Simulated ultrasound probe

• Computer

• Monitor or TV

Page 10: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Mannequin Based Simulators

• Display

1. Virtual anatomic model image

• Augmented reality

2. Ultrasound image

• Rendered image or

• Actual ultrasound image from a stored dataset

Page 11: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Mannequin Based Simulators

Page 12: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Phantom Type Simulators

• Use a real ultrasound unit to image a phantom

• Examples – Phantom containing a non-beating solid heart model

to demonstrate cardiac anatomy and scan planes

– Phantoms to practice ultrasound guided procedures • Vascular access

• Thoracentesis

• Paracentesis

Page 13: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Phantom Type Simulators

Page 14: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Phantom Type Simulators

Vascular Access

Page 15: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Phantom Type Simulators

Paracentesis Phantom

Page 16: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Phantom Type Simulators

Needle

Fluid

Paracentesis Phantom

Page 17: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

US Simulator Uses in Medical Education

1) Teaching Tool

2) Assessment Tool

Page 18: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Anatomy

• Demonstrate in situ anatomic relationships

• Demonstrate cross sectional anatomy

– B mode

– Augmented Reality

• Complement the gross lab dissections

Page 19: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Anatomy

Page 20: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Physiology

• Demonstrate direction of blood flow with color doppler

• Demonstrate motion of cardiac walls and valves at different points in the cardiac cycle

• Correlate this motion with ECG tracing

Page 21: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Physiology

Page 22: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Physiology

Page 23: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Physiology

Page 24: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Pathology

• Some simulators offer pathology in addition to normal scans

• Examples

– Pericardial effusion

– Thrombus in left ventricle or left atrium

– Dilated cardiomyopathy

– Aortic dissection

Page 25: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Pathology

• Allows students to image pathology they may not otherwise get a chance to directly scan

• Similar to baseball players getting to practice hitting a 100 MPH fastball

Page 26: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Image Acquisition

• Ultrasound is very operator dependent

• Some views are more difficult than others and require manual dexterity to obtain

Page 27: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Image Acquisition

• Simulators can help students develop their image acquisition skills through practice

• Some simulators can give visual feedback about how to properly manipulate the probe to obtain a high quality image

Page 28: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Image Acquisition

• Similar to pilots practicing their skills on a flight simulator

Page 29: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Procedural Skills

• Students can practice performing invasive ultrasound guided procedures

– Vascular access

– Thoracentesis

– Paracentesis

• Students can sharpen their skills in a no risk setting before attempting the procedures on a real patient

Page 30: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Teaching Tool for Procedural Skills

• Similar to practicing on this guy before getting on the back of a 2,000 pound rodeo bull

Page 31: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

US Simulator as an Assessment Tool

1) Target scan planes

– Measure the time it takes to obtain the desired scan plane

– Track the probe manipulations the student uses to achieve the target plane

Page 32: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

US Simulator as an Assessment Tool

2) Proper Measurement Technique

Page 33: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

US Simulator as an Assessment Tool

3) Incorporate ultrasound simulator pathology into an OSCE

– Students obtain a history and physical exam on a standardized patient

– Then they acquire images on the simulator which

displays that particular pathology

– Finally they formulate a diagnosis

Page 34: Ultrasound Simulators - Ultrasound Education for … · Ultrasound Simulators ... –Phantoms to practice ultrasound guided procedures • Vascular access ... Teaching Tool for Image

Summary

• Various types of ultrasound simulators are available

• Provide the opportunity for more hands on training

• Can be incorporated into medical education as both training and assessment tools


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