International Journal of Healthcare Simulation

Background and aim:

A local course has been delivered since 2018 to provide training in rare, time-critical, life-saving procedures that emergency medicine trainees may need to perform, including emergency lateral thoracotomy. Previously pig thoraxes have been used to provide thoracotomy training in this course. In 2022 a part-task model was purchased for thoracotomy training to replace this. We compare the use of this to animal models in our provision of simulation teaching of this skill.

Activity:

Animal models are useful due to availability, low cost, and provision of hands-on experience for learners. However, there are associated ethical, religious, psychological limitations with using animals for educational purposes. They may less accurately represent human anatomy and pathology. Their timely acquisition can pose a challenge with defrosting requirements and variable condition which can impact on the quality of training. There are infection risks due to fluid leakage, associated unpleasant odour and animal products require incineration for disposal.

The high-fidelity part-task mannequin can anatomically and physiologically replicate the thoracotomy experience to provide realistic simulation training. The mannequin is equipped with realistic external human features and internal organ anatomy, including a beating heat and blood, to provide an immersive training experience. It is reusable with repair, which could be cost-effective long term and more environmentally-friendly. This model enables thoracotomy skill practice in a safe, controlled environment without infection risk. Another advantage is the ability to provide standardized training, better allowing for objective evaluation of performance which can be challenging with animal models.

Findings:

This model (Figure 1-A108) has been a source of highly stimulating learning for both faculty and participants taking part in the course. The accurate anatomy has given an enhanced learning of real time simulated emergency requiring lateral thoracotomy and this has been reflected in participant feedback. There was a significant upfront cost which will depend on the continuation of the course, committed faculty and upkeep of the model to prove it cost-effective in the long run. The education team attended a course on the repair and maintenance of the model and it takes approximately 4-6hours to clean and repair the model after each use. The model requires a large heavy box for safe storage posing a relative burden given its infrequent use.

Figure 1-A108:

The immersive lateral thoracotomy model we are using, which is fully repairable to be used multiple times for authentic learner experience

Conclusion:

There are disadvantages to use of this model for the department, but the overall learning experience and sustainability is felt to be superior to animal models for training in emergency thoracotomy.

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.