Pus under pressure: a new part task trainer to simulate the procedure for drainage of a small abscess under local anaesthesia

Abstract

Aims: Following creation of the wearable trainer for medical student learning of urinary catheterisation, a preliminary evaluation of its realism, ease of use and training attributes compared to current commercial trainers was conducted. This trainer itself and the result of this evaluation are presented in this paper. Background: The trainer that we describe in this study was developed in response to three concerns about existing commercial trainers available for learning the skill of urinary catheterisation. First, the part task trainers commercially available encourage a focus only on the psychomotor components of catheterisation. Their ‘disembodied’ nature leads to neglect of the critical human dimensions of procedure, such as patient consent and human care. Second, students learning on existing commercial trainers complained of their ‘plastic’ nature, which reduced the realism of the experience. Third, existing trainers are very expensive, precluding their use by students unsupervised for self-directed learning practice.

The authors saw an opportunity to address these problems through the development of a new wearable catheterisation trainer. Key factors in this development included collaboration with an Australian company, Technology Concepts, which had developed a novel elastomeric polymer that approximates the characteristics of human skin, and a development grant from the Griffith Enterprise Innovation Fund.

Methods: Year 2 medical students were invited to participate in the evaluation. Participants were randomised by coin-toss to practice with either the prototype new trainer first then an existing commercial part-task trainer or vice versa. They completed questionnaires before and after each practice session.

Results: 105 students participated. Participants rated the new trainer as being much more accurate in simulating performance of the procedure on a real patient (mean score 7.3cm vs 3.3cm on a 10cm visual analogue scale, p<0.0001) and randomisation arm did not impact significantly on participants' ratings. Among 91 participants who offered an opinion on which better simulated the human dimensions of the procedure, 100% nominated the new trainer.

Conclusions: Other data to be presented and participants' direct comments indicate that both better simulation of human tissues and wearability by a simulated patient contributed to participants' preference for the new trainer. The improved simulator offers the potential for students performing the procedure for the first time on hospital patients to be better prepared.

The new trainer offers better simulation of urinary catheterisation in relation to both realism and the human dimensions of the procedure.