VCOM Carolinas Research Day 2023

Simulation and Technology

LOW-COST PRODUCTION OF OPHTHALMIC TRAUMA TRAINER FOR FOREIGN BODY REMOVAL Yash Patel, OMS-II; Christopher Jue, OMS-II; Jordan Paugh, OMS-II; Nicholas Minner, OMS-II; Michael Parks, MPA; Stacey Stokes; Tom Lindsey, DO . Edward Via College of Osteopathic Medicine, Spartanburg, SC.

Abstract # SIM-4

Introduction

Model Design

Data

Study Design : This project will use a within subjects design to self-evaluate confidence and competency as part of a quality analysis and improvement project. The subjects of this study consist of first-year medical students. Prior to the simulation, students will be given an assessment with statements of confidence and competency in managing ophthalmic cases on a 7 point Likert scale. Following the simulation students will again self-assess their ability to perform treatments related to superficial ocular trauma and glaucoma. To determine the difference between pre- and post-test values, a paired samples T-test will be performed. Simulation Development: This simulation training involves one self-assessment station, a short didactic training module, and four skill stations. The training module will cover superficial ocular trauma and glaucoma. The four skill stations will teach foreign body removal with a hollow-bore needle and the use of Tono-Pen, Woods Lamp, and Slit Lamp. Physicians will be guiding the medical students at each station on correct technique and answering any questions on the procedure. Objective: The aim of this project is to create a low-cost, realistic eye model to educate first and second year medical students and improve their skills in foreign body removal. Students that participate in the simulation training using the eye model will be more comfortable to use common eye assessment equipment and better prepared to diagnose and treat ocular injuries. Methods ● Superficial eye injury and extraocular foreign bodies accounted for approximately two-thirds of eye-related emergency department visits between 2006-2013. 1 ● Globally, glaucoma is the leading cause of irreversible blindness and is projected to affect 111.8 million by 2040. 2 ● Diagnosis and treatment of these conditions requires skilled usage of tools such as a Tono-Pen, slit lamp, and Woods lamp. 3 ● Inadequate knowledge or improper usage of these tools can prolong diagnosis and cause complications, such as infection, corneal perforation, or vision loss. 1 ● With rapid advancements of medical technology and practice, simulation-based learning has been increasingly utilized to improve knowledge and skills while preventing unnecessary risks in the medical field. 4 ● Previous simulations have utilized harvested bovine eyes, which can be more realistic but infeasible, or required extensive material and preparation time. ● Although ophthalmic trauma is infrequent, early diagnosis and treatment is essential for best outcomes. 1 ● Development of reusable, affordable, and high-fidelity trainers to teach healthcare providers how to perform corneal foreign body removal and utilize common eye assessment tools. 5 ● This novel eye model can be used by physicians or residents and be included in ophthalmic didactic medical curricula to prepare medical students as they enter their clinical rotations. 6

Model Design: The overall design contains three parts. The eye mechanism and eyeball, the containment device, and the mannequin mold. The eyelids and attachments were all 3D printed using 1.75 mm PLA filament. To connect the eyelids and their attachments, the team used M2 hex socket cap head screws with a thread size of 2 mm. To attach the eye mechanism to the containment device, neodymium disc magnets were used. This allows the eye mechanism to be removed to replace the eyeball after each use. Several materials were attempted to mimic the human eyeball. The team will create an eye using platinum catalyzed silicone to see how it compares to other designs. The containment device will also be 3D printed using the 1.75 mm PLA filament. This device will be cylindrical and house the other end of the neodymium disc magnet. The containment device will be secured to the mannequin. The team will also be creating synthetic skin using a mold around the containment device. With this design, the team hopes to create a realistic model for foreign body removal and a way to practice using common ophthalmic instruments.

Figure 2 . Depicts the 5-point Likert scale used to assess student confidence and competency related to management of ocular trauma and glaucoma. This assessment would be utilized before and after simulation experience in order to assess quality of learning. Additional questions included may relate to a student’s overall satisfaction with the simulation experience.

Conclusion

Result: The finished ocular trainer has a working eye mechanism with realistic eyeball for students to practice using a Tono-Pen, Woods Lamp, and Slit-Lamp. The cost of the project was less than 500 USD and each reproducible ocular trainer will cost less than 100 USD.

● It is vitally important for physicians to be trained in the safe practice of foreign body removal and glaucoma management to prevent agonizing pain and potential loss of vision. 5 ● To be practically attainable, simulation trainers should be high-fidelity and affordable. ● Every medical student should be familiar with utilization of a Tono-Pen, Slit Lamp, and Woods Lamp by the start of clinical rotations. The ultimate goal of simulation training for medical students is to better prepare students to perform these common-practice procedures. Future research will further examine the benefits of this trainer in medical education.

Acknowledgements

The authors of this poster would like to acknowledge and thank the Edward Via College of Osteopathic Medicine Carolinas Campus Simulation Center staff for their assistance and guidance in developing this simulation.

References

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