Integrating Virtual-reality based Ultrasound Tutorials for Developing Point-of-Care Skill Sets and Spatial Anatomy during a Medical Anatomy Course with OPUS Mini Haptic Ultrasound Simulator

SMYTHE Ciaran1, Brion BENNINGER1-9. Medical Anatomy Center1, Departments of Medical Anatomical Sciences2, Neuromuscular Medicine3, Family Practice4, Western University of Health Sciences, COMP–Northwest, Lebanon, OR. USA.... [ view full abstract ]

SMYTHE Ciaran1, Brion BENNINGER1-9. Medical Anatomy Center1, Departments of Medical Anatomical Sciences2, Neuromuscular Medicine3, Family Practice4, Western University of Health Sciences, COMP–Northwest, Lebanon, OR. USA. Departments of Orthopaedics5, General Surgery6 and Sports Medicine7, Samaritan Health Services, Corvallis, OR. USA. Departments of Surgery8, Orthopaedics & Rehabilitation9, Oregon Health & Science University, Portland, OR. USA.

INTRODUCTION. Point-of-care local anesthetic nerve blocks are commonly used in adults to attenuate postoperative pain and in pediatrics for fracture reduction and pain relief. In particular, femoral and sciatic nerve blocks are important for orthopedic surgery of the hip, knee, ankle joints, and lower limb fractures. Point-of-care ultrasound to assist in administering anesthesia continues to improve patient care as it facilitates a safer nerve block environment for patient and physician. Therefore, early training of medical students through integrating ultrasound simulation with in situ scanning can develop safe and efficient ultrasound operators. Medical students with ultrasound basics could allow residency programs to accelerate ultrasound training. The objective of this study was to assess if medical students could operate the OPUS-Mini Medical Skills (OMMS) trainer system to perform femoral and sciatic nerve blocks during concurrent cadaver dissections and use it during examinations. METHODS. Literature search was conducted regarding OMMS trainer system integrated into a medical school curriculum for an anatomy dissection course. The OMMS trainer system is an ultrasound simulator using haptics technology for lifelike experience on a split screen viewing cross-sectional anatomy and ultrasound imaging while performing femoral and sciatic blocks. 18 first-year medical students were provided formal 20-minute tutorials on using the OMMS trainer system with a supplementary 3D clay model to view the anatomy of the invasive procedure. Individual students were mentored using the OMMS system and encouraged to use it during non-teaching hours. RESULTS. All students successfully acquired necessary skills and relevant anatomy for femoral and sciatic blocks. 18 out of 18 students accurately identified anatomy and performed the blocks during formal anatomy lab assessment. DISCUSSION. Literature search revealed no known studies integrating the OMMS system during an undergraduate medical curriculum. Ultrasound is an essential part of residency training and medical schools feel it is important to provide baseline skillsets. Many schools are introducing students to ultrasound fundamentals during clinical years, developing a baseline while cultivating probe handling and image acquisition. This study integrated functional anatomy regarding cadaver dissection, 3D clay model palpation and observation, invasive procedures, cross-modal perception, and simulation during a lab based anatomy course. Likert scale survey revealed that students found the technology and skills associated with the OMMS system very helpful, especially during dissection of the block regions. The success of this pilot study will now be applied to scalene blocks in the neck dissection region. CONCLUSION. This study successfully incorporated ultrasound simulation with haptic technology and split screen cross-sectional anatomy and ultrasound imaging to provide skillsets to first year medical students during a lab based anatomy dissection course.