Granular jamming based controllable organ design for abdominal palpation

Medical manikins play an essential role in the training process of physicians. Currently, most available simulators for abdominal palpation training do not contain controllable organs for dynamic simulations. In this paper, we present a soft robotics controllable liver that can simulate various liver diseases and symptoms for effective and realistic palpation training. The tumors in the liver model are designed based on granular jamming with positive pressure, which converts the fluid-like impalpable particles to a solid-like tumor state by applying low positive pressure on the membrane. Through inflation, the tumor size, liver stiffness, and liver size can be controlled from normal liver state to various abnormalities including enlarged liver, cirrhotic liver, and multiple cancerous and malignant tumors. Mechanical tests have been conducted in the study to evaluate the liver design and the role of positive pressure granular jamming in tumor simulations

Robotic simulators for tissue examination training with multimodal sensory feedback

Tissue examination by hand remains an essential technique in clinical practice. The effective application depends on skills in sensorimotor coordination, mainly involving haptic, visual, and auditory feedback. The skills clinicians have to learn can be as subtle as regulating finger pressure with breathing, choosing palpation action, monitoring involuntary facial and vocal expressions in response to palpation, and using pain expressions both as a source of information and as a constraint on physical examination. Patient simulators can provide a safe learning platform to novice physicians before trying real patients. This paper reviews state-of-the-art medical simulators for the training for the first time with a consideration of providing multimodal feedback to learn as many manual examination techniques as possible. The study summarizes current advances in tissue examination training devices simulating different medical conditions and providing different types of feedback modalities. Opportunities with the development of pain expression, tissue modeling, actuation, and sensing are also analyzed to support the future design of effective tissue examination simulators

Focal Spot, Fall 1979

https://digitalcommons.wustl.edu/focal_spot_archives/1024/thumbnail.jp

Desenvolvimento e avaliação de simuladores como recursos didáticos para o treinamento de habilidades clínico veterinárias

Orientadora : Profª Drª Simone Tostes de Oliveira StedileCo-orientadora : Profª Drª Carla Forte Maiolino MolentoDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências Agrárias, Programa de Pós-Graduação em Ciências Veterinárias. Defesa: Curitiba, 24/03/2015Inclui referênciasÁrea de concentração : Ciências veterináriasResumo: O uso de métodos alternativos para o treinamento de procedimentos clínicos na Medicina Veterinária constitui uma possibilidade de superar dois grandes problemas atuais: um de ordem ética, que é a utilização de animais vivos como recursos didáticos, e outro de ordem técnica, que é a oportunidade limitada de os estudantes desenvolverem e exercitarem suas capacidades clínicas. Simultaneamente, o desenvolvimento de métodos alternativos possibilita a implementação do princípio ético dos 3Rs, substituição, redução e refinamento do uso de animais no ensino. Considerando-se as vantagens do uso de métodos alternativos, desenvolveu-se um simulador de paciente canino que permitiu aos estudantes o treinamento da técnica de palpação prostática. O uso de métodos alternativos para o treinamento clínico ainda é um assunto negligenciado em muitos cursos de Medicina Veterinária, o que motivou a segunda parte deste trabalho, a elaboração de um guia para a realização de uma oficina sobre métodos alternativos com o intuito de expandir o conhecimento ético e técnico dos participantes. A oficina resultou em um notável envolvimento dos participantes com o tema e na criação de quatro modelos alternativos para o treino de procedimentos clínicos. Palavras-chave: educação humanitária, substituição, aprendizado prático, métodos alternativos, ética.Abstract: The use of alternative methods for clinical training in veterinary medicine is an opportunity to overcome two major issues in contemporary practice: an ethical one, which is the use of live animals as teaching resources, and a technical one, which is the limited opportunity for students to develop and exercise their clinical skills. Simultaneously, the development of alternative methods enables the implementation of the ethical principle of the 3Rs, replacement, reduction and refinement of animal use in teaching. Considering the advantages of using alternative methods, we developed a canine patient simulator that allowed students to train the prostate palpation technique. The use of alternative methods for the clinical training is still a neglected subject in many veterinary medicine courses, which led us to the second part of this work, the development of a guide for conducting a workshop on alternative methods in order to expand ethical and technical knowledge of the participants. The workshop resulted in a notable participant involvement with the topic and the creation of four alternative models for training of clinical procedures. Keywords: humane education, replacement, practical learning, alternative methods, ethics

An Abdominal Phantom with Tunable Stiffness Nodules and Force Sensing Capability for Palpation Training

Robotic phantoms enable advanced physical examination training before using human patients. In this paper, we present an abdominal phantom for palpation training with controllable stiffness liver nodules that can also sense palpation forces. The coupled sensing and actuation approach is achieved by pneumatic control of positive-granular jammed nodules for tunable stiffness. Soft sensing is done using the variation of internal pressure of the nodules under external forces. This paper makes original contributions to extend the linear region of the neo-Hookean characteristic of the mechanical behavior of the nodules by 140% compared to no-jamming conditions and to propose a method using the organ level controllable nodules as sensors to estimate palpation position and force with a root-means-quare error (RMSE) of 4% and 6.5%, respectively. Compared to conventional soft sensors, the method allows the phantom to sense with no interference to the simulated physiological conditions when providing quantified feedback to trainees, and to enable training following current bare-hand examination protocols without the need to wear data gloves to collect data.This work was supported in part by the Engineering and Physical Sciences Research Council (EPSRC) MOTION grant EP/N03211X/2 and EP/N03208X/1, and EPSRC RoboPatient grant EP/T00603X/

Focal Spot, Winter 1984/85

https://digitalcommons.wustl.edu/focal_spot_archives/1039/thumbnail.jp

SIMULATION: PERCEPTIONS OF FIRST YEAR ASSOCIATE DEGREE NURSING STUDENTS

It was the purpose of this study to determine if there is a relationship between student satisfaction with high-fidelity-patient simulation experience and self-confidence in learning among student nurses. The population was associate nursing degree students. The study measured by the students’ perceptions of their satisfaction and self-confidence. There is a need for pedagogical adaptations using high-fidelity simulations to provide meaningful teaching to the nursing students. At this time, further research is needed to determine the relationship between satisfaction and the level of self-confidence among students experiencing high-fidelity- patient simulators. In order to examine the relationship of students’ satisfaction and level of self-confidence in learning, students enrolled in a first-year associate degree nursing program in south Texas were recruited to participate in this study. After obtaining institutional review board approval, data were collected at the completion of the course. Demographic information was obtained and the students were asked to complete the survey tools developed by the National League of Nursing. This study used a correlational design to achieve the purposes of the research. Correlational design was useful because the researcher was seeking to discover statistically significant relationships between variables. This study examined the relationship between the variables of student satisfaction and self-confidence. The results of the study demonstrated that the students’ were satisfied and felt self-confident after the simulation interaction; however, there was a weak positive correlation between the two variables. viiCurriculum and Instruction, Department o