VCOM Carolinas Research Day 2023

Simulation and Technology

CREATING A LOW-COST ABDOMINAL SURGERY SIMULATOR TO INCREASE AVAILABILITY AND EXPOSURE TO SURGICAL CONCEPTS AND CAPABILITIES IN DIDACTIC MEDICAL TRAINING . Shea Fincher, OMS-II, Victoria Mae Koniuk, OMS-II, Tom Lindsey DO, FACOS, CHSE, Michael Parks MPA, MREMT. Edward Via College of Osteopathic Medicine, Simulation Center, Spartanburg, SC.

Abstract # SIM-1

Background

Theoretical Results

Conclusions

• Simulation learning provides hands-on, compartmentalized training, with immediate feedback in a controlled and safe setting (1,8). • Interactive learning with simulators enhances retention by 45% compared to audiovisual learning (7,11). • The ACS/APDS/ASE Resident Preparatory Curriculum was created in 2013 to strengthen the skills of fourth-year medical students entering surgical residencies (9). Critical Component 6, Operative Anatomy, can be learned most realistically using simulation throughout preclinical medical education. • Cost and accessibility are hindering medical institutions’ ability to properly integrate simulation-based curriculum (6). To combat the lack of surgical simulation in undergraduate medical education, we created a low-cost abdominal surgery simulator for use during instructional years.

Graph 1. Box Plot of Control Group Gastrointestinal Anatomy Exam 1 scores.

• With data to reject the null hypothesis, we postulate that second-year medical students' performance on their Gastrointestinal Anatomy Exam 1 will significantly improve with the use of our simulator. • The major assumption made in this data was that our experimental group will have a baseline increase of 2 points in the minimum and maximum grades achieved on the Block 5 Gastrointestinal Anatomy exam. • Upon completion of our project, we will perform a Cost Benefit Analysis to evaluate the monetary impact of our abdominal simulator versus similar commercially available surgery simulators. • As a continuation of our research, we plan to evaluate the impact of our simulator on surgical rotation performance by comparing post-rotation examination scores between our two groups. • With the rapid expansion of current technology and procedural capabilities, the integration of surgical simulation into medical curricula is necessary for the adequate training of our future surgeons. • We hope that our low-cost abdominal simulator will offer repeatable procedural training for both academic and non academic medical institutions, and therefore help to mitigate the inaccessibility of high-fidelity simulators to medical students and practicing physicians alike.

Graph 2 . Box Plot of Experimental Group Gastrointestinal Anatomy Exam 1 scores.

Objective

Medical students using our simulator during instructive years will better understand abdominal anatomy and thus perform better on their gastrointestinal anatomy examinations.

Development

Table 1 . Data Set Values of our groups .

• To develop organs, we first accessed public STL files of an Abdominal CT scan. • The STL files were printed using 3D technology. • The 3D-printed abdominal organs were molded and cast using Reynold’s Advanced Materials products. • The completed organs will be contained in a simulator shell to represent an abdominal cavity.

Simulator Development:

Data Collection:

References

Acknowledgements

• We plan to test the efficacy of our simulator by conducting a randomized control trial on OMS-2 students. One group will have exposure to our simulator, and one will use only the traditional curriculum. • Both groups will complete the Gastrointestinal Anatomy Exam 1 in Block 5. • These scores will be deidentified, and a Student’s T -Test will be used to determine if there is a statistically significant difference in performance between groups. • To represent our future methods, we accessed the Class of 2025 Gastrointestinal Anatomy Exam 1 statistics from Canvas by Instructure, Graph 1. We predicted our experimental group to achieve a 2-point increase in the minimum and maximum scores on the same examination, Graph 2.

This project was supported by Edward Via College of Osteopathic Medicine-Carolinas Campus and funded by the Simulation Center. Special thanks to members of the Abdominal Simulator Team.

• Our theoretical results yielded a 2-tailed Unpaired T-Test value of 0.0086 . Since this value is p < 0.05, we can conclude that our theoretical data shows a statistically significant increase in grades. • Our theoretical results yielded a 95% Confidence Interval of -2.78883 to -0.41117 . Since this confidence interval does not include 0, we can conclude that the null hypothesis of the simulator not having an effect can be rejected.

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